City of Calumet City

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

78164 Issued in IL

Legal business name

CITY OF CALUMET CITY

Practice address

684 Wentworth Ave
Calumet City, IL 60409-4241

Phone

(708) 891-8145

Fax

(708) 891-3241

NPI assigned

Jun 4, 2006

Last updated

Dec 6, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Glenn Bachert

Title

Chief

Phone

(708) 891-8145

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575590400000",
    "number": "1841239217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1053",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604482052",
            "telephone_number": "708-478-5694",
            "fax_number": "708-478-5879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "684 WENTWORTH AVE",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604094241",
            "telephone_number": "708-891-8145",
            "fax_number": "708-891-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF CALUMET CITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2019-12-06",
        "status": "A",
        "authorized_official_last_name": "BACHERT",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "708-891-8145"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "78164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARMONY WELLCARE",
            "identifier": "2237310",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1671109",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "590005386",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Barbara Clark-Arzuaga, COTA/L
• Eunice K. Clay, COTA/L
• Kim Cobb, MSW, LCSW
• Mary Collins

• Land Ambulance in Calumet City, IL
• Providers in Calumet City, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.